Charaka Siddhisthana Chapter 4 - Sneha Vyapat Siddhi

This article explains the third chapter of siddhisthana of Charaka samhita called 'Snehavyapat Siddhi Adhyaya'. In this chapter, management of complications arising from the administration of anuvasana basti are explained.

Prologue
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athatah snehavyapatsiddhim vyakhyasyamah||1||
iti ha smaha bhagavanatreyah||2||
We shall now explore the chapter dealing with "the management of complications arising from the Administration of Anuvasana Basti (unctuous enema)". Thus, said Lord Atreya [1-2]

Table of Contents

Topics covered

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snehabastinnibodheman vatapittakaphapahan|
mithyapranihitanam ca vyapadah sacikitsitah||3||

Sage Atreya to Agnivesha and other disciples: Now listen to the description of the following topics:
Recipes for Sneha or Anuvasana Basti for the treatment of diseases caused by Vata, Pitta and Kapha,
Complications arising from their wrongful administration and
Treatment of these complications [3]

Anuvasana Recipe for Vata (Bilva Taila)

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dasamulam balam rasnamasvagandham punarnavam| guducyerandabhutikabhargivrsakarohisam||4||
satavarim sahacaram kakanasam palamsikam | yavamasatasikolakulatthan prasrtonmitan||5||
caturdrone'mbhasah paktva dronasesena tena ca| tailadhakam samaksiram jivaniyaih palonmitaih||6||
anuvasanametaddhi sarvavatavikaranut|

One Pala each of Dashamoola, Bala, Rasna, Asvagandha, Punarnava, Guduchi, Eranda, Bhutika (Yavani) Bhargi, Vrushaka (Vasa), Rohisa, Shatavari, Sahacara as well as Kakanasa (Vayasi Phala), and one Prasruta (two Palas) each of Yava, Atasi, Kola as well as Kulattha is added with four Dronas (one Drona= 256 Palas) of water, and cooked till one Drona of the liquid remains. To this decoction, one Adhaka (64 Palas) each of oil and milk, and the paste of one Pala each of Jivaka, Rsabhaka, Meda, Mahameda, Kakoli, Ksirakakoli, Mudgaparni, Mashaparni, Jivanti and Madhuka are added. Anuvasana Basti (unctuous enema) with this recipe cures all the diseases caused by vata. [4 - 1/2 7]

Other Anuvasana Recipes for vata:

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anupanam vasa tadvajjivaniyopasadhita||7||
satahvayavabilvamlaih siddham tailam samirane|
saindhavenagnitaptena taptam canilanuddhrtam||8|

Anuvasana Basti prepared of vasa (muscle fat) of animals inhabiting marshy land (Anupa desha), boiled with drugs belonging to Jivaniya group (Jivaka, Rsabhaka, Meda, Mahameda, Kakoli, Ksirakakoli, Mudgaparni, Mashaparni, Jivanti and Madhuka), similarly cures Vatika diseases.
Anuvasana Basti with the oil cooked by Satahva, Yava, Bilva and sour juice is also useful in vatika diseases.
Anuvasana Basti with ghee which has been heated by the immersion of hot rock-salt cures diseases caused by vata. [7 1/2 - 8]

Recipe of Anuvasana Basti for Pitta (Jivaniya -Yamaka)

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jivantim madanam medam sravanim madhukam balam| satahvarsabhakau krsnam kakanasam satavarim||9||
svaguptam ksirakakolim karkatakhyam satim vacam| pistva tailam ghrtam ksire sadhayettaccaturgune||10||
brmhanam vatapittaghnam balasukragnivardhanam| mutraretorajodosan harettadanuvasanam||11||

Ghee and oil taken together may be cooked by adding four times of milk along with the paste of Jivanti, Madana Phala, Meda, Sravani, Madhuka, Bala, Satahva, Rsabhaka, Krsna (Pippali), Karkanasa, Shatavari, Svagupta (Atmagupta), Ksirakakoli, Karkatakhya (Karkata Srngi), Sati and Vaca. Anuvasana Basti with this recipe is nourishing, alleviator of vata and Pitta, promoter of strength, semen and Agni (power of digestion including metabolism) and curative of urinary, seminal and menstrual morbidities. [9-11]

Another Anuvasana Recipe for Pitta

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labhatascandanadyaisca pistaih ksiracaturgunam| tailapadam ghrtam siddham pittaghnamanuvasanam||12||
Ghee cooked with four times of milk, one fourth in quantity of oil, and the paste of drugs belonging to Chandanadi group whichever are available, is used for anuvasana basti which alleviates Pitta. [12]

Anuvasana Recipe for Kapha

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saindhavam madanam kustham satahvam niculam vacam| hriveram madhukam bhargim devadaru sakatphalam||13||
nagaram puskaram medam cavikam citrakam satim| vidangativise syamam harenum nilinim sthiram||14||
bilvajamode krsnam ca dantim rasnam ca pesayet| sadhyamerandajam tailam tailam va kapharoganut||15||
vradhnodavartagulmarsahplihamehadhyamarutan| anahamasmarim caiva hanyattadanuvasanat||16||
Castor oil, sesame oil is cooked by adding the paste of Saindhava (rock-salt), Madana, Kustha, Satahva, Nicula, Vaca, Hrivera, Madhuka, Bhargi, Devadaru, Katphala, Nagara, Puskara, Meda, Cavika, Chitraka, Sati, Vidanga, Ativisa, Syama, Hraenu, Nilini, Sthira, Bilva, Ajamoda, Krsna, Danti and Rasna. Anuvasana Basti with this medicated oil cures the below mentioned diseases -
Kaphaja diseases,
Bradhna (inguinal enlargement),
Udavarta (upward movement of wind in the abdomen),
Gulma (phantom tumour),
Arshas (piles),
Plihan (splenic disorders),
Meha (obstinate urinary diseases including diabetes),
Adhya-vata (a joint disease), Anaha (tympanites) and
Asmari (calculus) [13-16]
Read: Basti Chikitsa: Benefits, Routes, Types, Indications, Equipment

Another Anuvasana recipe for kapha (Madana- Taila)

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madanairva'mlasamyuktairbilvadyena ganena va| tailam kaphaharairva'pi kaphaghnam kalpayedbhisak||17||
Oil cooked with Madana Phala by adding sour liquid (vinegar etc.) or by adding (the decoction as well as paste of) Bilva, Syonaka, Gambhari, Patala, Ganikarika, Salaparni, Prsniparni, Brhati, Kantakari and Gokshura, or by adding Kapha alleviating drugs may be used for Anuvasana Basti for the alleviation of kapha. [17]

Recipe for Anuvasana Basti

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vidangairandarajanipatolatriphalamrtah| jatipravalanirgundidasamulakhuparnikah||18||
nimbapathasahacarasampakakaravirakah| esam kvathena vipacettailamebhisca kalkitaih||19||
phalabilvatrivrtkrsnarasnabhunimbadarubhih| saptaparnavacosiradarvikusthakalingakaih||20||
latagaurisatahvagnisaticorakapauskaraih | tat kusthani krimin mehanarsamsi grahanigadam||21||
klibatam visamagnitvam malam dosatrayam tatha| prayuktam pranudatyasu panabhyanganuvasanaih||22||
Oil is cooked by adding the decoction of Vidanga, Eranda, Rajani, Patola, Haritaki, Amalaki, Amrta, tender leaves of Jati, Nirgundi, Bilva, syonaka, Gambhari, Patala, ganikarika, Salaparni, Prsniparni, Brhati, Kantakari, Gokshura, Akhuparni, Nimbi, Patha, Sahacara, Sampaka, and Karavira and the paste of Madana phala, Bilva, Trivrt, Krsna, Rasna, Kalinga, Lata (manjistha), Gauri (haridra), Satahva, Agni, Sati, Coraka and Puskaramula.
Administration of this medicated oil as potion, for massage or for Anuvasana Basti immediately cures -
Kustha (skin diseases),
Krimi (parasitic infestation),
Meha (obstinate urinary disorders including diabetes),
Arshas (piles),
Grahani (sprue),
Klibata (impotency),
Visamagni (irregular digestion),
Mala (production of morbid matter in excess) and
diseases caused by all the three Doshas [18-22]

Effects of Anuvasana Basti in General

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vyadhivyayamakarmadhvaksinabalanirojasam| ksinasukrasya cativa snehavastirbalapradah||23||
padajanghoruprsthamsakatinam sthiratam param| janayedaprajanam ca prajam strinam tatha nrnam||24||
Sneha or Anuvasana Basti [administered with the above mentioned medicated oils] promotes excessive strength of persons who are emaciated and debilitated because of long suffering from diseases, excessive exercise, hard labour, walking long distance, loss of Ojas (vital essence) and diminution of semen. It causes excellent stability of feet, calves, thighs, back, shoulder and lumbar region. It helps in the procreation of off springs by the sterile men and women. [23-24]
Read: Anuvasana Basti: Method, Benefits, Mode Of Action, Contra Indications

Conditions Leading to Complications

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vatapittakaphatyannapurisairavrtasya ca| abhukte ca pranitasya snehabasteh sadapadah||25||
Improper administration of Anuvasana Basti may give rise to complications in following six conditions:
Vatavruta Sneha - Occlusion of the enema-fluid by vata
Pittavruta Sneha - Occlusion of the enema-fluid by Pitta
Kaphavruta Sneha - Occlusion of the enema - fluid by kapha
Ati anna avruta Sneha - Occlusion of the enema-fluid by food, taken in excess
Pureeshavruta sneha - Occlusion of enema- fluid by faeces; and
Administration of enema on empty stomach [25]

Factors responsible for occlusion of enema-fluid

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sito'lpo va'dhike vate pitte'tyusnah kaphe mrduh| atibhukte gururvarcahsancaye'lpabalastatha||26||dattastairavrtah sneho na yatyabhibhavadapi [1] |abhukte'navrtatvacca yatyurdhvam tasya laksanam||27||
The Sneha (unctuous fluid of anuvasana basti) being occluded does not reach its destination because of the following:
Sheeta - If cold recipe is used
Alpa - small quantity for unctuous enema when vata is aggravated;
If excessively hot recipes are used for unctuous enema when Pitta is aggravated;
If mild recipe is used for unctuous enema when Kapha is aggravated;
If heavy recipe is used for unctuous enema when the patient has consumed food in excess quantity
If a recipe of mild nature is used for unctuous enema when there is accumulation of stool; and
If the recipe is afflicted because of excessively aggravated Doshas
If the patient has not taken food before the administration of unctuous enema the enema recipe reaches upwards much above the desired level because of the absence of any obstruction.
Hereafter, the signs of different impediments will be described. [26-27]

Signs of impediments by Vata

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angamardajvaradhmanasitastambhorupidanaih parsvarugvestanairvidyat sneham vatavrtam bhisak||28||
The physician should ascertain the obstruction of the unctuous fluid by Vata from the signs and symptoms like malaise, fever, adhmana (flatulence), sita (feeling of cold), stambha (stiffness), uru pidana (pain in the thighs), Parsvaruk (pain in the sides of the chest) and Parsva vestana (cramps in the sides of the chest). [28]

Treatment of Vata Impediment vatavruta Sneha

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snigdhamlalavanosnaistam rasnapitadrutailikaih |sauvirakasurakolakulatthayavasadhitaih||29||
niruhairnirharet samyak samutraih pancamulikaih| tabhyameva ca tailabhyam sayam bhukte'nuvasayet||30||
The occlusion [of the enema-fluid by Vata] is removed by the administration of Niruha-Basti with the recipes of Rasnadi Taila and Pitadru Taila having the characteristic features as follows:
those which are added with unctuous, sour, saline and hot ingredients
those which are prepared by adding sauviraka (vinegar), Sura (alcohol), Kola Kulattha and Yava and
those which are mixed with cow's urine, and the decoction of Bilva, Syonaka, Gambhari, Patala and Ganikarika.
After the evening meals, the patient is given anuvasana basti with the above mentioned Rasna Taila and Pitadru Taila. [29-30]

Signs and treatment of Pitta Impediments Pittavruta sneha

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daharagatrsamohatamakajvaradusanaih| vidyat pittavrtam svadutiktaistam bastibhirharet||31||
The occlusion [of the unctuous enema-fluid] by Pitta can be confirmed by the presence / manifestation of burning sensation, redness, morbid thirst, unconsciousness, tamaka (entering into darkness) and fever.
This occlusion can be removed by the administration of enema containing sweet and bitter ingredients. [31]

Signs of kapha Impediments Kaphavruta Sneha

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tandrasitajvaralasyaprasekarucigauravaih| sammurcchaglanibhirvidyacchlesmana snehamavrtam||32||
The occlusion of the unctuous enema fluid by Kapha can be ascertained from the affliction of the patient by drowsiness, cold fever, indolence, salivation, anorexia, heaviness, fainting and depression (Glani). [32]
Read: Uttara Basti: Method, Indications, Mode of Action

Treatment of Kapha Impediments

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kasayakatutiksnosnaih suramutropasadhitaih|phalatailayutaih samlairbastibhistam vinirharet||33||
The occlusion (of the unctuous fluid by Kapha) can be removed by the administration of Basti prepared by alcohol and cow's urine by adding Madana Phala Taila, as well as astringent, Pungent, sharp hot and sour ingredients. [33]

Signs of impediments by Intake of Food in Excess

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chardimurccharuciglanisulanidrangamardanaih|amalingaih sadahaistam vidyadatyasanavrtam||34||
The occlusion (of the unctuous fluid) by the intake of food in excess can be ascertained from the afflictions of the patient by vomiting, fainting, anorexia, depression, colic pain, excessive sleep, malaise, signs of Ama (caused by the product of improper digestion and metabolism) and burning sensation. [34]
Read: Matra Basti: Indications, Benefits, Contra Indications

Treatment of Impediments Caused by Intake of food in Excess

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katunam lavananam ca kvathaiscurnaisca pacanam| vireko mrduratramavihita ca kriya hita||35||
For the type of occlusion (of unctuous fluid by the intake of food in excess), Pacana (metabolic transformation of the undigested products) with pungent and saline decoctions as well as powders, mild purgation and therapies prescribed for correcting Ama (product of improper digestion and metabolism) are useful. [35]

Signs and Treatment of Impediments by Stool

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vinmutranilasangartigurutvadhmanahrdgrahaih| sneham vidavrtam jnatva snehasvedaih savartibhih||36||
syamabilvadisiddhaisca niruhaih sanuvasanaih| nirharedvidhina samyagudavartaharena ca||37||
The occlusion (of the unctuous enema-fluid) by stool can be ascertained from the afflictions of the patient by the obstruction to the passage of stool, urine and flatus, pain heaviness, flatulence and cardiac spasm.
Such a patient is treated by oleation, fomentation and Phala Varti (medicated suppository) therapies with Syama, Bilva, etc., Niruha Basti followed by Anuvasana Basti is given appropriately for the removal of obstruction. The treatment of Udavarta (an ailment characterized by upward movement of wind) too shall be considered. [36-37]

Ailments caused by Basti on Empty Stomach, Treatment

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abhukte sunyapayau va vegat sneho'tipiditah|dhavatyurdhvam tatah kanthadurdhvebhyah khebhya etyapi||38||
mutrasyamatrivrtsiddho yavakolakulatthavan|tatsiddhataila isto'tra niruhah sanuvasanah||39||
kanthadagacchatah stambhakanthagrahavirecanaih|chardighnibhih kriyabhisca tasya karyam nivartanam||40||
If the Anuvasana Basti is given on an empty stomach or on an emptied bowel or if the enema-fluid is injected with great force it goes up speedily, and comes out from the throat or through the orifices in the upper part of the body.
In this condition, oil cooked with cow's urine, Syama Trivrt, Yava, Kola and Kulattha is used for giving Niruha and anuvasana types of medicated enema.
If the enema-fluid starts coming out of the throat, then the patient is given Stambhana therapies (like fanning and sprinkling with cold water); pressure is applied over his throat [to prevent further upward movement of the enema- fluid], and he is given purgative and anti-emetic therapies. [38-40]

Non- elimination of Enema-fluid

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yasya nopadravam kuryat snehabastiranihsrtah| sarve'lpo va"vrto rauksyadupeksyah sa vijanata||41||
If because of un-unctuousness, the unctuous enema fluid, being obstructed, does not get eliminated totally or partially, but the condition is not associated with complications, then an expert physician should leave the patient alone (i.e., he should not try to bring out the fluid by therapies) [41]

Diet after Anuvasana Basti

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yuktasneham dravosnam ca laghupathyopasevanam| bhuktavan matraya bhojyamanuvasyastryahattryahat||42||
After appropriate administration of Anuvasana Basti, the patient is given liquid, hot, light and wholesome food. After the intake of this food in appropriate quantity, the patient may repeatedly be given Anuvasana Basti every third day. [42]

Hot water

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dhanyanagarasiddham hi toyam dadyadvicaksanah| vyusitaya nisam kalyamusnam va kevalam jalam||43||
snehajirnam jarayati slesmanam tadbhinatti ca| marutasyanulomyam ca kuryadusnodakam nrnam||44||

vamane ca vireke ca niruhe sanuvasane| tasmadusnodakam deyam vataslesmopasantaye||45||
In the next morning, after the night, the expert physician should be given water boiled with Dhanyaka and Nagara (Sunthi) or simple warm water.
This warm water helps the patient in the digestion of undigested fat and it disintegrates Kapha. Therefore, after emesis, purgation, Niruha and Anuvasana therapies, warm water is to be given to the patient for the alleviation of Vata and Kapha. [43-45]
Read: Vaitarana Basti - Ingredients, Benefits

Frequency of Anuvasana Basti

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ruksanityastu diptagnirvyayami marutamayi| vanksanasronyudavrttavatascarha dine dine||46||
esam casu jaram sneho yatyambu sikatasviva| ato'nyesam tryahatprayah sneham pacati pavakah||47||
Anuvasana Basti can be given every day in the below mentioned conditions / persons -
Persons who are habituated to taking un-unctuous food,
Those who have strong Agni (power of digestion and metabolism),
Those who perform physical exercise,
Those who are afflicted with Vatika diseases,
Those whose pelvic region and hip region are afflicted with Vata, and
Those who are suffering from Udavarta - bloating (upward movement of Vata)
As the water falling over sand gets absorbed immediately, similarly the fat given to these patients gets immediately digested.
In the case of others, the Agni (digestive enzymes) generally digests Sneha (fat) in three days. [46-47]

Prohibition of Uncooked fat

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na tvamam pranayet sneham sa hyabhisyandayedgudam| savasesam ca kurvita vayuh sese hi tisthati||48||
Uncooked fat is not used for Anuvasana Basti as it produces stuffiness (Abhisyanda) in the rectum.
Some portion of the fat (enema- liquid) is allowed to remain in Basti (bladder -which is used as receptacle of enema-fluid) because it contains air. [48]

Prohibition of fat after Anuvasana

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na caiva gudakanthabhyam dadyat snehamanantaram| ubhayasmat samam gacchan vatamagnim ca dusayet||49||
After the administration of anuvasana Basti, fat should not be given through the anus or mouth, because the fat coming from both the sides (upper and lower) simultaneously vitiates Vata and Agni (enzymes responsible for digestion). [49]

Prohibition of Exclusive administration of Niruha and Anuvasana

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snehabastim niruham va naikamevatisilayet| utklesagnivadhau snehanniruhat pavanadbhayam||50||
tasmannirudhah samsnehyo niruhyascanuvasitah| snehasodhanayuktyaivam bastikarma tridosanut||51||

Either Niruha or Anuvasana should not be taken in excess (without interruption by the other). Excessive administration of Anuvasana [exclusively] gives rise to Utklesa (excitement of Kapha and Pitta) and suppression of the power of digestion. Excessive administration of Niruha [exclusively] leads to the risk of Vata getting aggravated.
Therefore, after Niruha-Basti, the patient is given Anuvasana Basti, and after Anuvasana Basti, Niruha Basti is given. Thus, by giving anuvasna and Niruha appropriately (one after the other), this Basti therapy cures the diseases caused by all the three Doshas. [50-51]

Matra-Basti

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snehabastim niruham va naikamevatisilayet| utklesagnivadhau snehanniruhat pavanadbhayam||50||
tasmannirudhah samsnehyo niruhyascanuvasitah| snehasodhanayuktyaivam bastikarma tridosanut||51||
Matra Basti is always useful for persons emaciated by Karma (playing with ball, etc.), Vyayama (practicing archery etc.), carrying heavy load, long way-faring, riding vehicles or indulging in sexual intercourse with women and for persons who are weak and who are afflicted with Vatika diseases.
While taking Matra basti, a person can take any food, and may do any work as he likes. It can be safely administered in all the seasons.
The dose of Matra Basti is equal to the minimum quantity in which Anuvasana Basti is prescribed to be administered. This Matra Basti which is a form of Anuvasana basti promotes strength and can be administered easily. It helps in easy voiding (elimination) of stool. It causes nourishment, and cures diseases caused by aggravated Vata. [52-54]

Epilogue
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????????? ?????????? ??????? ???????????| ????? ????????????????? ??????? ????????????||??||
???????????? ??????????????? ?????? ??????????????????? ?? ?????????????????????? ????????????????????||??||
To sum up tatra slokau-
vatadinam samayoktah pravarah snehabastayah| tesam cajnaprayuktanam vyapadah sacikitsitah||55||
pragbhojyam snehabasteryad dhruvam ye'rhastryahacca ye snehabastividhiscokto matrabastividhistatha||56||:

In this chapter, the topics described are as follows:
1. foremost recipes of Anuvasana Basti for the alleviation (elimination) of aggravated Vata etc., (vide verse nos. 4-24)
2. complications arising out of their administration by ignorant persons, and treatment of these complications (vide verse nos. 25-41)
3. diet to be given before the administration of Anuvasana Basti (vide verse nos. 42-45)
4. persons for whom anuvasana basti is indicated to be taken every day and for whom it is indicated on every third day; (vide verse nos, 46-47)
5. the method of administration Anuvasana Basti and (vide verse nos. 48-51)
6. the methods of administering Matra Basti (vide verse nos. 52-54)

??????????????? ??????? ????????????????????????? ?????????????? ???????????? ??????????????????????? ??????????????||?||
ityagnivesakrte tantre carakapratisamskrte'prapte drdhabalasampurite siddhisthane snehavyapatsiddhirnama caturtho'dhyayah||4||

Thus ends the fourth chapter in Siddhi-Sthana dealing with "the successful treatment of complications arising out of unctuous enema" in the text composed by Agnivesha, redacted by Caraka and because of its Non-availability, supplemented by Drdhabala.

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